Effectiveness of Atlas Transverse Process Resection Combined With Release and Perfusion Techniques in Treating Clinical Symptoms Caused by Internal Jugular Vein Stenosis Secondary to External Compression.

Abstract

The objective is to evaluate the surgical outcomes of partial atlas transverse process resection, with or without additional release and perfusion techniques, in the treatment of internal jugular vein stenosis from external compression. A retrospective cohort study was conducted on patients who underwent surgery from January 2020 to September 2022 and had J3 segment stenosis of the internal jugular vein owing to osseous compression. Computed tomographic venography, contrast-enhanced magnetic resonance angiography, and Doppler ultrasonography were incorporated into the preoperative and postoperative evaluations at 1 week and 3 months to measure the diameter of the internal jugular vein and hemodynamic parameters. A visual analog scale was employed to quantify the severity of symptoms. The outcomes of 2 surgical approaches were compared: isolated lateral partial atlas transverse process resection (isolated group, n = 15) and combined resection with release and perfusion techniques (combined group, n = 32). The treatment group exhibited substantially superior outcomes at the 1-week follow-up among 47 patients (mean age 52.53 ± 13.76, including 24 males): In the treatment group, the symptom improvement rate was 62.5% (20 out of 32 patients), while in the control group, it was 20% (3 out of 15 patients). In the treatment group, 84.3% (27 out of 32 patients) of the patients experienced stenosis alleviation, while 46.67% (7 out of 15 patients) of the patients in the control group did. The control group demonstrated improvement in 40.0% (6 out of 15 patients), while the treatment group demonstrated hemodynamic improvement in 75.0% (24 out of 32 patients). All results were statistically significant (P < 0.05). The treatment group (20%) and the control group (12.5%, P = 0.815) were not significantly different in terms of complication rates during the 3-month follow-up. In comparison to isolated osseous decompression, the combined surgical protocol, which incorporates partial atlas transverse process resection, release, and perfusion techniques, exhibits superior anatomical restoration, hemodynamic recovery, and symptom relief, while maintaining comparable safety profiles.